AFS STUDENT EXCHANGE PLAN application form Essay

Preliminary Application Form

Borang Permohonan

Recent Photography

Gambar Terbaik

All forms must be HANDWRITTEN clearly in black or perhaps blue printer ink pen and every question should be answered. Pada borang hendaklah ditulis dengan jelas sama ada dalam dakwat hitam atau biru sahaja. Sila jawab sepenuhnya soalan dengan lengkap.

CHECKLIST – SENARAI SEMAK

Make sure that you have completed ALL the information on this form and includes: Semak semula SETIAP maklumat yang telah diisi dan ikutkan perkara-perkara beserta:

A RM20 cheque/postal order/money order produced payable to ‘Yayasan Antarabudaya Malaysia' RM20 dalam motif cek/wang pos/kiriman wang dicipta atas sebutan ‘Yayasan Antarabudaya Malaysia'

Your past 2 years' university results (Compulsory)

Keputusan peperiksaan yang terkini bagi two tahun yang lalu (Wajib)

A photocopy of your IC both sides

Satu salinan jogei pengenalan (kedua-dua belah)

A newly released passport image of yourself

Gambar berukuran passport yang terbaru.

PERSONAL INFORMATION – MAKLUMAT PERIBADI

Term (as in IC) (Mr/Ms) - Nama (seperti dalam dalam

IC Number -- Nombor Jogei Pengenalan

K/P) Encik/Cik

Male or female - Jantina

House Phone Number - Nombor Telefon Griya

Postal Talk about - Alamat Rumah

Cellphone Number - Nombor Telefon Bimbit

Email - Petunjuk Email

ADDITIONAL INFORMATION – MAKLUMAT LAIN

Just how did you hear about AFS? - Bagaimanakah anda mengenal mengenai AFS? Online

College

Road Present

Internet

Sekolah

Promosi Bergerak

Friends

Paper

Others

Kawan

Suratkhabar

Lain-lain

My favored countries are (kindly consider the list of programs offered): Negara-negara pilihan saya (Sila rujuk senarai program yang ditawarkan): 1 )

2 .

3.

(We simply cannot guarantee your first choice nevertheless we will perform our best! ) - (Kami bukan memberi sebarang jaminan kita akan mendapat pilihan mulailah anda. )

About your affinity for the AFS Program

Sila Pilih Daripada Program-program Berikut

Departing in:

I i am interested in

Saya berminat bagi mengikuti:

Bulan Berlepas:

Season Program (11–12 months)

Rigorous Program (6–8 weeks)

Dec/Jan/Feb/March

Program Setahun (11-12 bulan)

Program Intensif (6–8 minggu)

Dis/Jan/Feb/Mac

Session Program (6 months)

Very Short Plan (2 – 4 weeks)

Jun/July/Aug/Sept

Plan Semester (6 bulan)

Program Pendek (2 – 5 minggu)

Jun/Julai/Ogos/Sept

www.afsmas.org

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SCHOOL INFORMATION – MAKLUMAT SEKOLAH

Identity of School - Nama Sekolah

School Talk about - Petunjuk Sekolah

Phone number - Nombor Telefon

Send Number - Nombor Fax

I am in Form (Kindly present class name) - Saya di Tingkatan (SIla catitkan nama kelas) Post held in school (if any)- Jawatan disandang dalam sekolah

INFORMATON ABOUT FATHER AND MOTHER / MOM OR DAD (S) MAKLUMAT IBUBAPA as well as PENJAGA Daddy / Stepfather / Protector - Bapa / Bapa Tiri as well as Penjaga

Employer - Majikan

Occupation -- Pekerjaan

Office Number - Nombor Pejabat

Mobile Amount - Nombor Telefon Bimbit

Email Adress - Petunjuk Email

Mother / Stepmother / Protector - Ibu / Ibu Tiri / Penjaga

Workplace - Majikan

Occupation - Pekerjaan

Business office Number - Nombor Pejabat

Mobile Quantity - Nombor Telefon Bimbit

Email Adress - Tanda Email

CRISIS CONTACT – MAKLUMAT KECEMASAN

If your father and mother / protector cannot be reached, please indicate someone else in your community whom we are able to contact:

Andai ibubapa/penjaga kamu tidak meraih dihubungi, sila nyatakan maklumat orang (selain keluarga) yang boleh dihubungi:

Full Name - Nama Full

Office Phone - Telefon Pejabat

Marriage - Hubungan

House Mobile phone - Telefon Rumah

HOSTING – PENEMPATAN PELAJAR ASING

Have any of your family members participated on an AFS program? Adakah sesiapa daripada ahli family anda sempat menyertai system AFS?

Simply no

Yes, who, where and which yr

Tidak

En este momento, Jika ya, sila sertakan nama, negeri serta tahun penyertaan

Are you or any of your family members involved in AFS?

Adakah anda atau sesiapa daripada...

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